ACL Injury Mechanism in Alpine Skiing: Analysis of an Accidental ACL Rupture

2009 ◽  
pp. 63-63-19 ◽  
Author(s):  
M Barone ◽  
V Senner ◽  
P Schaff
Keyword(s):  
Acl Injury ◽  
Injury Mechanism ◽  
Acl Rupture ◽  
Alpine Skiing

scholarly journals Ski-geometric parameters do not differ between ACL injury mechanisms in recreational alpine skiing

2021 ◽  
Author(s):  
Markus Posch ◽  
Gerhard Ruedl ◽  
Klaus Greier ◽  
Martin Faulhaber ◽  
Katja Tecklenburg ◽  
...  
Keyword(s):  
Risk Taking ◽  
Injury Severity ◽  
Acl Injury ◽  
Injury Mechanism ◽  
Geometric Parameters ◽  
Alpine Skiing ◽  
Body Rotation ◽  
Injury Mechanisms ◽  
Risk Taking Behavior ◽  
Forward Falls

Abstract Purpose It is not known so far if ski-equipment-related factors differ between the ACL injury mechanisms, potentially influencing the circumstances and causes of falling, finally resulting in ACL injury. More specifically focusing on the injury mechanisms will provide a deeper understanding of injury causation. The aim of the study was to evaluate whether ACL injury mechanisms in recreational alpine skiing differ with regard to ski-geometric parameters, self-reported circumstances and causes of accident and injury severity. Methods Among a cohort of 392 ACL-injured (57.9% females) skiers, age, sex, height, weight, skill level, risk-taking behavior, circumstances and causes of accident, and ACL injury severity were collected by questionnaire. Additionally, patients had to recall their type of fall (ACL injury mechanism) by classifying forward and backward falls with and without body rotation. Ski length, side cut radius and widths of the tip, waist and tail were directly notated from the ski. Results The forward fall with body rotation was the most common reported ACL injury mechanism (63%). A riskier behavior was associated with forward falls without body rotation. Ski-geometric parameters did not significantly influence the type of ACL injury mechanism. Regarding accident characteristics, catching an edge of the ski was more frequent (p < 0.001) the cause for forward falls (75% and 67%) when compared to the backward falls (46 and 15%) and executing a turn was the most frequent action in all falls (39–68%). A complete rupture of the ACL (66–70%) was more commonly reported than a partial tear (30–34%) among all four non-contact ACL injury mechanisms (n.s.). Conclusion In contrast to risk-taking behavior and accident characteristics, ski-geometric parameters and injury severity do not significantly differ between ACL injury mechanisms in recreational skiing. Thus, an individual skiing style seems to have more impact on ACL injury mechanisms than ski equipment. Future studies should evaluate potential effects of ski geometry on the incidence of ACL injury. Level of evidence III.

Experiences of returning to elite alpine skiing after ACL injury and ACL reconstruction

2014 ◽  
Vol 26 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Birgitta Nordahl ◽  
Rita Sjöström ◽  
Maria Westin ◽  
Suzanne Werner ◽  
Marie Alricsson
Keyword(s):  
High School Students ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Alpine Skiing ◽  
Structured Interviews ◽  
School Students ◽  
Physical Ability ◽  
Acl Injuries ◽  
Elite Level ◽  
Passive Strategies

Abstract Aim: To explore the experiences of alpine skiing at the elite level after anterior cruciate ligament (ACL) injury and reconstruction. Design: A qualitative approach where semi-structured interviews were conducted, and an analysis of the manifest content was performed. Participants: Five ski high school students, two male and three female skiers, who had suffered ACL injuries and undergone ACL reconstructions. Results: Seven categories were identified. The participants described their perceived opportunities with regard to returning to alpine skiing after ACL injury and reconstruction as something positive to do with self-belief, being mentally and physically prepared, regaining confidence in their own ability, being given time and using active strategies. In contrast, perceived barriers to a return to elite alpine skiing gave rise to negative feelings, for example, fear, disheartenment, a total lack of or ambivalent confidence in their own ability and the use of passive strategies. Conclusion: The two male skiers returned to alpine skiing. They reported confidence in their own ability, active strategies and support on all levels, as well as enhanced physical ability. The female skiers did not return to their pre-injury level of competitive alpine skiing. They stated a lack of support on all levels, deterioration in their physical ability and two out of three reported passive strategies and no or ambivalent confidence in their own ability. The most important factors were family support, support on all levels, access to a physiotherapist and time given.

scholarly journals No Association Between Risk of Anterior Cruciate Ligament Rupture and Selected Candidate Collagen Gene Variants in Female Elite Athletes From High-Risk Team Sports

2018 ◽  
Vol 47 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Einar Andreas Sivertsen ◽  
Kari Bente Foss Haug ◽  
Eirik Klami Kristianslund ◽  
Anne-Marie Siebke Trøseid ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Elite Athletes ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Acl Rupture ◽  
Acl Injuries ◽  
Genes Encoding ◽  
Anterior Cruciate

Background: Several single-nucleotide variants (SNVs) in collagen genes have been reported as predisposing factors for anterior cruciate ligament (ACL) tears. However, the evidence is conflicting and does not support a clear association between genetic variants and risk of ACL ruptures. Purpose: To assess the association of previously identified candidate SNVs in genes encoding for collagen and the risk of ACL injury in a population of elite female athletes from high-risk team sports. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 851 female Norwegian and Finnish elite athletes from team sports were included from 2007 to 2011. ACL injuries acquired before inclusion in the cohort were registered by interview. The participants were followed prospectively through 2015 to record new complete ACL injuries. Six selected SNVs were genotyped ( COL1A1: rs1800012, rs1107946; COL3A1: rs1800255; COL5A1: rs12722, rs13946; COL12A1: rs970547). Results: No associations were found between ACL rupture and the SNVs tested. Conclusion: The study does not support a role of the 6 selected SNVs in genes encoding for collagen proteins as risk factors for ACL injury. Clinical Relevance: Genetic profiling to identify athletes at high risk for ACL rupture is not yet feasible.

Muscle Activity Patterns of Elite Downhill Ski Racers during Landing

1996 ◽  
Vol 12 (2) ◽  
pp. 225-236
Author(s):  
Peter Schaff ◽  
Lars Nordsletten ◽  
Arne Kristian Aune
Keyword(s):  
Motor Control ◽  
Muscle Activity ◽  
Activity Patterns ◽  
Bending Moment ◽  
Acl Injury ◽  
Potential Effect ◽  
Acl Rupture ◽  
Maximum Loading ◽  
Control Pattern ◽  
Downhill Skiing

The purpose of this study was to examine motion and muscle activity in downhill skiing in order to estimate muscular involvement during the landing phase and its potential effect on ACL injury. Specially developed 8-channel portable electromyo-graphy registration was conducted during three jumps on the Russi jump of the 1994 Olympic downhill slope, and six control jumps were carried out in the laboratory. The results reveal that the skier adapts to the expected loading of the knee, possibly by using a learned motor control pattern. It is still not clear, however, how important muscular adaptation to expected forces is. The complex functional EMG pattern that skiers use while landing indicates that ACL rupture caused during a backward fall in downhill skiing might be due to a combination of the boot-top-induced anterior shear, the force generated in the ACL by forceful knee hyperflexion supported by the high bending moment generated by a stiff spoiler, and the possible absence of a significant protecting hamstrings force during maximum loading.

Loss of patellofemoral cartilage thickness over 5 years following ACL injury depends on the initial treatment strategy: results from the KANON trial

2019 ◽  
Vol 53 (18) ◽  
pp. 1168-1173 ◽  
Author(s):  
Adam G Culvenor ◽  
Felix Eckstein ◽  
Wolfgang Wirth ◽  
L Stefan Lohmander ◽  
Richard Frobell
Keyword(s):  
Treatment Strategy ◽  
Controlled Trial ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Cartilage Thickness ◽  
Acl Rupture ◽  
Thickness Loss ◽  
Patellar Cartilage ◽  
Randomised Controlled ◽  
The Impact

ObjectivesTo evaluate changes in patellofemoral cartilage thickness over 5 years after anterior cruciate ligament (ACL) injury and to determine the impact of treatment strategy.Methods121 adults (ages 18–35 years, 26% women) had an ACL injury and participated in the KANON randomised controlled trial. Of those, 117 had available MRIs at baseline (<4 weeks post-ACL rupture) and at least one follow-up measurement (2, 5 years). Patellofemoral cartilage thickness was analysed by manual segmentation (blinded to acquisition order). Patellar, trochlear and total patellofemoral cartilage thickness changes were compared between as-randomised (rehabilitation+early ACL reconstruction (ACLR) (n=59) vs rehabilitation+optional delayed ACLR (n=58)) and as-treated groups (rehabilitation+early ACLR (n=59) vs rehabilitation +delayed ACLR (n=29) vs rehabilitation alone (n=29)).ResultsPatellofemoral cartilage thickness decreased −58 µm (95% CI −104 to –11 µm) over 5 years post-ACL rupture, with the greatest loss observed in trochlea during the first 2 years. Participants randomised to rehabilitation+early ACLR had significantly greater loss of patellar cartilage thickness compared with participants randomised to rehabilitation+optional delayed ACLR over the first 2 years (−25 µm (−52, 1 µm) vs +14 µm (−6 to 34 µm), p=0.02) as well as over 5 years (−36 µm (−78 to 5 µm) vs +18 µm (−7, 42 µm), p=0.02). There were no statistically significant differences in patellofemoral cartilage thickness changes between as-treated groups.ConclusionPatellofemoral (particularly trochlear) cartilage thickness loss was observed in young adults following acute ACL rupture. Early ACLR was associated with greater patellofemoral (particularly patellar) cartilage thickness loss over 5 years compared with optional delayed ACLR, indicating that early surgical intervention may be associated with greater short-term structural patellofemoral cartilage deterioration compared with optional delayed surgery.Trial registration numberISRCTN84752559; Post-results.

External Loading at the Knee Joint for Landing Movements in Alpine Skiing

1992 ◽  
Vol 8 (1) ◽  
pp. 62-80 ◽  
Author(s):  
Lynda Read ◽  
Walter Herzog
Keyword(s):  
Knee Joint ◽  
Knee Flexion ◽  
Inverse Dynamics ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
External Loading ◽  
Alpine Skiing ◽  
Joint Forces ◽  
Anterior Cruciate ◽  
Resultant Forces

The purpose of this study was to determine resultant knee joint forces and moments during a specific movement in Alpine ski racers. The movement analyzed consisted of a landing from a bump and the initiation of recovery (if necessary). Resultant loads were obtained using an inverse dynamics approach. Results of two specific skiers are contrasted, one skier landing in good form, the second skier landing in poor form. The skier landing in poor form exhibited larger knee flexion, and larger knee joint resultant forces and moments than the skier landing in good form. The movement of the skier landing in poor form has been associated with isolated anterior cruciate ligament (ACL) injury. However, the data obtained in this study do not indicate that either skier was in danger of ACL injury.

scholarly journals Timing sequence of multi-planar knee kinematics revealed by physiologic cadaveric simulation of landing: Implications for ACL injury mechanism

2014 ◽  
Vol 29 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Ata M. Kiapour ◽  
Carmen E. Quatman ◽  
Vijay K. Goel ◽  
Samuel C. Wordeman ◽  
Timothy E. Hewett ◽  
...  
Keyword(s):  
Knee Kinematics ◽  
Acl Injury ◽  
Injury Mechanism ◽  
Cadaveric Simulation

scholarly journals Risk Factors for Anterior Cruciate Ligament Injury in Competitive Adolescent Alpine Skiers

2018 ◽  
Vol 6 (4) ◽  
pp. 232596711876683 ◽  
Author(s):  
Maria Westin ◽  
Marita L. Harringe ◽  
Björn Engström ◽  
Marie Alricsson ◽  
Suzanne Werner
Keyword(s):  
Risk Factors ◽  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Left Knee ◽  
Alpine Skiing ◽  
Acl Injuries ◽  
Alpine Skiers ◽  
Anterior Cruciate ◽  
Reduced Risk

Background: There is a high risk for anterior cruciate ligament (ACL) injuries in alpine skiers. To reduce or try to prevent these injuries, intrinsic and extrinsic risk factors need to be identified. Purpose: To identify possible intrinsic and extrinsic ACL injury risk factors among competitive adolescent alpine skiers. Study Design: Case-control study; Level of evidence, 3. Methods: Between 2006 and 2009, a cohort of 339 alpine ski students (176 male, 163 female) from Swedish ski high schools were prospectively observed in terms of ACL injuries. First-time ACL injuries were recorded. In September, prior to each ski season, the skiers were clinically examined according to a specific knee protocol. Results: Overall, 11 male and 14 female skiers sustained a total of 25 first-episode ACL injuries. The majority of injuries occurred in the left knee ( P < .05). Skiers who had participated in alpine skiing for >13 years (hazard ratio, 0.83; 95% CI, 0.68-1.00; P < .05) had a reduced risk of sustaining an ACL injury. Eighteen ACL injuries occurred during training, 12 in the technical discipline of giant slalom, and 8 in slalom. Fourteen skiers reported not to be fatigued at all at the time of injury, and 8 skiers reported that they were somewhat fatigued. Conclusion: ACL injuries occurred more often in the left knee than the right. This should be taken into consideration in the design of ACL injury prevention programs. Those who reported a higher number of active years in alpine skiing showed a reduced risk of sustaining an ACL injury. No other factor among those studied could be identified as an independent risk factor for ACL injury.

Tibiofemoral contact and alignment in patients with anterior cruciate ligament rupture treated nonoperatively versus reconstruction

2021 ◽  
Vol 103-B (9) ◽  
pp. 1505-1513
Author(s):  
David J. Stockton ◽  
Andrew M. Schmidt ◽  
Andrew Yung ◽  
Jane Desrochers ◽  
Honglin Zhang ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Contact Area ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Rupture ◽  
Healthy Controls ◽  
The Mean ◽  
Anterior Cruciate ◽  
Time Since Injury ◽  
Centroid Location

Aims Anterior cruciate ligament (ACL) rupture commonly leads to post-traumatic osteoarthritis, regardless of surgical reconstruction. This study uses standing MRI to investigate changes in contact area, contact centroid location, and tibiofemoral alignment between ACL-injured knees and healthy controls, to examine the effect of ACL reconstruction on these parameters. Methods An upright, open MRI was used to directly measure tibiofemoral contact area, centroid location, and alignment in 18 individuals with unilateral ACL rupture within the last five years. Eight participants had been treated nonoperatively and ten had ACL reconstruction performed within one year of injury. All participants were high-functioning and had returned to sport or recreational activities. Healthy contralateral knees served as controls. Participants were imaged in a standing posture with knees fully extended. Results Participants’ mean age was 28.4 years (SD 7.3), the mean time since injury was 2.7 years (SD 1.6), and the mean International Knee Documentation Subjective Knee Form score was 84.4 (SD 13.5). ACL injury was associated with a 10% increase (p = 0.001) in contact area, controlling for compartment, sex, posture, age, body mass, and time since injury. ACL injury was associated with a 5.2% more posteriorly translated medial centroid (p = 0.001), equivalent to a 2.6 mm posterior translation on a representative tibia with mean posteroanterior width of 49.4 mm. Relative to the femur, the tibiae of ACL ruptured knees were 2.3 mm more anteriorly translated (p = 0.003) and 2.6° less externally rotated (p = 0.010) than healthy controls. ACL reconstruction was not associated with an improvement in any measure. Conclusion ACL rupture was associated with an increased contact area, posteriorly translated medial centroid, anterior tibial translation, and reduced tibial external rotation in full extension. These changes were present 2.7 years post-injury regardless of ACL reconstruction status. Cite this article: Bone Joint J 2021;103-B(9):1505–1513.

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